Connie Rae Willis, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

00715070 Issued in NU

Practice address

1 Freedom Way
Augusta, GA 30904-6285

Phone

(706) 733-0188

NPI assigned

Oct 2, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235222894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 INWOOD DRIVE",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "29803",
            "telephone_number": "803-649-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046285",
            "telephone_number": "706-733-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "CONNIE",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": "00715070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keisha Ann Williford, OD
• Rebecca Williford
• Eleanor Willingham
• Alexandra Clark Willis
• Ashley Stanczak Willis, PNP
• Lauren Willis, PHD, PHARMD
• Samuel Andersen Willis, M.D.
• Stacy L Willis, BS
• Edward Terrell Wills, D.O.
• Mary Elizabeth Miller Willson, OTR/L

• Registered Dietitian in Augusta, GA
• Providers in Augusta, GA by specialty
• Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.